Tags

Type your tag names separated by a space and hit enter

Endoscopic histoacryl obliteration vs. propranolol in the prevention of esophagogastric variceal rebleeding: a randomized trial.
Endoscopy. 2003 Sep; 35(9):729-35.E

Abstract

BACKGROUND AND STUDY AIMS

The obliteration of esophageal and/or gastric varices using Histoacryl is highly effective in controlling active bleeding. However, it is not known whether repeated injections are useful for the long-term eradication of esophagogastric varices. The aim of the study was to compare endoscopic Histoacryl obliteration with propranolol in the secondary prevention of esophagogastric variceal bleeding.

PATIENTS AND METHODS

Between August 1995 and February 1999, 41 patients with a first bleeding from esophageal (n = 31) or gastric (n = 10) varices were included in the study. After primary hemostasis with obliteration using Histoacryl, patients were randomly allocated either to undergo complete Histoacryl obliteration of the remaining varices (group A, n = 21) or to long-term propranolol administration (group B, n = 20), for the prevention of rebleeding.

RESULTS

The two groups were well matched for age, sex, etiology of cirrhosis, Child-Pugh score, renal function, and infection at the time of admission. The median follow-up was 31.9 months (4.8 - 74.7) for group A and 23.2 months (3.0 - 70.0) for group B. Initial hemostasis was achieved in 40/41 patients (97 %). No significant difference was observed between groups A and B with regard to the incidence of early rebleeding (during the first 6 weeks; 5/21 and 3/20), bleeding-related deaths by 6 weeks (3/21 and 6/20), long-term rebleeding (11/21 and 5/20), or overall number of deaths (9/21 and 9/20). The incidence of complications was higher in group A (10/21) than group B (2/20) (P < 0.03).

CONCLUSIONS

Repeated injections of Histoacryl with the aim of eradicating esophagogastric varices are associated with more complications compared with beta-blocker administration, with similar results in terms of rebleeding rate and survival in the long term.

Authors+Show Affiliations

Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12929019

Citation

Evrard, S, et al. "Endoscopic Histoacryl Obliteration Vs. Propranolol in the Prevention of Esophagogastric Variceal Rebleeding: a Randomized Trial." Endoscopy, vol. 35, no. 9, 2003, pp. 729-35.
Evrard S, Dumonceau JM, Delhaye M, et al. Endoscopic histoacryl obliteration vs. propranolol in the prevention of esophagogastric variceal rebleeding: a randomized trial. Endoscopy. 2003;35(9):729-35.
Evrard, S., Dumonceau, J. M., Delhaye, M., Golstein, P., Devière, J., & Le Moine, O. (2003). Endoscopic histoacryl obliteration vs. propranolol in the prevention of esophagogastric variceal rebleeding: a randomized trial. Endoscopy, 35(9), 729-35.
Evrard S, et al. Endoscopic Histoacryl Obliteration Vs. Propranolol in the Prevention of Esophagogastric Variceal Rebleeding: a Randomized Trial. Endoscopy. 2003;35(9):729-35. PubMed PMID: 12929019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic histoacryl obliteration vs. propranolol in the prevention of esophagogastric variceal rebleeding: a randomized trial. AU - Evrard,S, AU - Dumonceau,J-M, AU - Delhaye,M, AU - Golstein,P, AU - Devière,J, AU - Le Moine,O, PY - 2003/8/21/pubmed PY - 2004/2/13/medline PY - 2003/8/21/entrez SP - 729 EP - 35 JF - Endoscopy JO - Endoscopy VL - 35 IS - 9 N2 - BACKGROUND AND STUDY AIMS: The obliteration of esophageal and/or gastric varices using Histoacryl is highly effective in controlling active bleeding. However, it is not known whether repeated injections are useful for the long-term eradication of esophagogastric varices. The aim of the study was to compare endoscopic Histoacryl obliteration with propranolol in the secondary prevention of esophagogastric variceal bleeding. PATIENTS AND METHODS: Between August 1995 and February 1999, 41 patients with a first bleeding from esophageal (n = 31) or gastric (n = 10) varices were included in the study. After primary hemostasis with obliteration using Histoacryl, patients were randomly allocated either to undergo complete Histoacryl obliteration of the remaining varices (group A, n = 21) or to long-term propranolol administration (group B, n = 20), for the prevention of rebleeding. RESULTS: The two groups were well matched for age, sex, etiology of cirrhosis, Child-Pugh score, renal function, and infection at the time of admission. The median follow-up was 31.9 months (4.8 - 74.7) for group A and 23.2 months (3.0 - 70.0) for group B. Initial hemostasis was achieved in 40/41 patients (97 %). No significant difference was observed between groups A and B with regard to the incidence of early rebleeding (during the first 6 weeks; 5/21 and 3/20), bleeding-related deaths by 6 weeks (3/21 and 6/20), long-term rebleeding (11/21 and 5/20), or overall number of deaths (9/21 and 9/20). The incidence of complications was higher in group A (10/21) than group B (2/20) (P < 0.03). CONCLUSIONS: Repeated injections of Histoacryl with the aim of eradicating esophagogastric varices are associated with more complications compared with beta-blocker administration, with similar results in terms of rebleeding rate and survival in the long term. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/12929019/Endoscopic_histoacryl_obliteration_vs__propranolol_in_the_prevention_of_esophagogastric_variceal_rebleeding:_a_randomized_trial_ DB - PRIME DP - Unbound Medicine ER -